Quality of life and sexual functioning in young women with early-stage breast cancer 1 year after lumpectomy. (original) (raw)

Quality of Life and Sexual Functioning of Women after Breast Cancer Surgery

Open Access Macedonian Journal of Medical Sciences

BACKGROUND: Women with breast cancer can experience changes in sexual functioning and body images that can seriously affect their quality of life. AIM: The aim of this research was to study the quality of life and sexual functioning of women after a mastectomy and after a breast-conserving surgery and to compare post-operative quality of life. SUBJECTS AND METHODS: This cross-sectional study included 204 participants, 101 patients after a mastectomy and 103 patients after a quadrantectomy. The research was conducted using the Croatian version of the questionnaire of the European Organization for Research and Treatment of Breast Cancer, the questionnaire with the breast cancer module EORTC QLQ - BR 23. RESULTS: On the EORTC QLQ –BR23 scale, participants with mastectomy rated their sexual functioning (p < 0.001), sexual pleasure (p < 0.001), and systemic side effects (p = 0.04) lower comparing to women after breast-conserving surgery. The overall functionality scale was signific...

Sexual Function in Breast Cancer Patients: A Review of the Literature

Clinical and Experimental Obstetrics & Gynecology

Background: Breast cancer (BC) is the most prevalent cancer among females worldwide. Despite having survival rates beyond 90% in 5 years nowadays, BC has also the highest rates of lost disability-adjusted life years (DALYs) among all cancers. Sexual dysfunction (SD) is one of the most important causes of the problem, affecting between 40-80% of BC survivors. However, SD remains underdiagnosed and undertreated in the clinical practice. Therefore, this review is aimed to evaluate the assessment of SD in Breast Cancer Survivors (BCS) as well as specific causes affecting their sexual function and the potential therapeutic options for these patients. Methods: In December 2021, a search of observational studies evaluating the sexual function in BCS was performed through Ovid Medline, Embase, PubMed, Cochrane register of controlled trials (CCTR), Cochrane database of systematic reviews (CDSR), Cumulative Index to Nursing & Allied Health Literature (CINAHL) and Google scholar to identify potentially relevant publications. Articles that evaluated non-gynecological cancers were excluded, as well as those focusing on the sexuality of men. Results: Despite being such a prevalent entity and given the particularities of how BC affects the sexuality of patients, SD is not usually discussed in the clinical practice in BCS for various reasons, remaining therefore underdiagnosed and undertreated. SD in BC patients has a multifactorial aetiology, including among others, the effect of BC treatments (related to vaginal mucosae, fatigue, and joint pain), the psychological impact of the diagnostic itself and sociocultural influences related to the alteration of the breast. Various strategies have been suggested to treat SD in BC patients, including pharmacological, physical and psychological options. Evidence shows that vaginal moisturizers and psyco-educational therapies focusing on sexual health and couple-based ones improve sexual function; while systemic treatments and general psychological therapy have not demonstrated benefit. Regarding exercise programmes, body image perception has shown to be improved after a one-year strength training program. Conclusions: SD is a multifactorial condition that affects the quality of life of millions of BCS worldwide, severely underdiagnosed and undertreated up to date. A systematic assessment of sexual function in BCS could be useful to diagnose all cases prematurely to give adequate care and prevent its worsening. Specific treatment options for BCS are key potential investigation targets for the near future.

Changes in sexual problems over time in women with and without early-stage breast cancer

Menopause, 2010

Objectives-We aimed to evaluate whether age-matched women with and without early-stage breast cancer differentially experience sexual problems over time and whether changes in patients' problems differ by surgery type. Methods-We conducted four interviews (4-6 weeks, 6 months, 1 year and 2 years) after surgery (patients) or a negative/benign screening mammogram (controls). Mixed-effects models with repeated ordinal measurements tested effects of time and diagnostic group (stages 0, I, IIA vs. controls) and, for patients, effects of time and type of surgery (mastectomy vs. lumpectomy), on a newly developed 9-item sexual-problems measure. Two-sided P-values < 0.05 were considered significant. Results-Using data from 1033 women (17.3% stage 0, 33.4% stage I/IIA, 49.3% controls; mean age 57.1; 23.1% non-white; 64.7% married), two factors measuring problems with sexual attractiveness and sexual interest/enjoyment emerged in exploratory factor analysis (alpha ≥ .74 for each subscale and the 9-item measure). Patients and controls reported few sexual problems on average, but compared with baseline, controls were more likely to report sexual problems on the 9item measure over time, and stage I patients were less likely to report problems with sexual attractiveness over time (each P < 0.05). Patients with mastectomy (35.7%) were 2.7 times more likely to report sexual problems on the 9-item measure at 2-year follow-up compared with baseline (P = 0.0339). Conclusions-Patients and controls experienced few sexual problems over time and, in fact, controls were more likely to report sexual problems at subsequent interviews, whereas patients did not.

Sexual Problems in Younger Women After Breast Cancer Surgery

Journal of Clinical Oncology, 2006

To examine sexual problems in younger women diagnosed with breast cancer during the first year after surgery and to identify sociodemographic, medical, and psychosocial predictors of sexual problems. Patients and Methods Women diagnosed with breast cancer age Յ 50 years completed surveys at three time points: within 24 weeks after initial surgery (baseline), 6 weeks after baseline, and 6 months later. Survey items included the Medical Outcomes Study Sexual Functioning Scale, satisfaction with sex life, feeling sexually attractive, body image, marital satisfaction, quality of life, medical history, symptoms, and sociodemographics. Prediagnosis sexual problems were retrospectively ascertained at the initial survey. Results Analyses included 209 women sexually active at baseline (78.6% of total sample). Sexual problems were significantly greater immediately postsurgery compared with retrospective reports before diagnosis (P Ͻ .0001). Although problems gradually decreased over time, they were still greater at 1 year postsurgery than before diagnosis. In multivariate analyses controlling for sexual problems at prediagnosis, vaginal dryness, and lower perceived sexual attractiveness were consistently related to greater overall sexual problems. Chemotherapy was related to sexual problems only at baseline except for women who became menopausal as a result of chemotherapy, who continued to have problems. Conclusion Findings substantiate the need to address potential sexual problems related to chemotherapy treatment and menopause among younger breast cancer survivors and to counsel women about possible remedies, particularly for vaginal dryness. Increasing feelings of sexual attractiveness may also help sexual problems, especially among women for whom these feelings were altered by surgery or treatment.

Sexual Dysfunction in Breast Cancer Survivors

Background: Approximately 12.3 percent of women will be diagnosed with breast cancer at some point during their lifetime. Breast cancer is accompanied by alternation in body image and worries about sexual attractiveness. Thus, sexual life of breast cancer survivor’s needs special attention. This study aimed to evaluate the effects of breast cancer on women’s sexual function. Methods: In this case-control study, 30 women who referred to surgical departments of breast cancer and 30 healthy women in Shiraz, Iran were selected through purposive sampling. These women underwent treatment during two months. The study data were gathered using a demographic questionnaire and a researcher-made questionnaire based on DSM-IV Diagnostic Criteria which evaluated the women’s sexual dysfunctions. Then, the data were entered into the SPSS statistical software (version 16) and were analyzed using descriptive statistics, chi-square, Mann-Whitney, and Kruskal-Wallis tests. Results: Two groups were matched according to age, education level, occupation, number of treatments for breast cancer, types of treatment and menopausal age. The results indicated that sexual desire disorder, sexual arousal disorder, and orgasmic disorder were more prevalent in the case group compared to the control group (P<0.05). In contrast, sexual pain disorder and aversion disorder were similar in the two groups. Moreover, a significant difference was found between the two groups concerning the sex-related imagination and fantasizing (P=0.007), lubrication, orgasm, and remaining aroused (P<0.05). The study results revealed no significant relationship between type of surgery and sexual dysfunction. Whereas, a significant relationship was observed between years after treatment and sexual dysfunction. Conclusion: Our findings showed that breast cancer adversely affects women’s sexual function. It is highly recommended to pay attention to the sexual aspect of the women with breast cancer using couple therapy.

Study of Sexual Functioning Determinants in Breast Cancer Survivors

The Breast Journal, 2005

Our goal was to identify the treatment, personal, interpersonal, and hormonal (testosterone) factors in breast cancer survivors (BCSs) that determine sexual dysfunction. The treatment variables studied were type of surgery, chemotherapy, radiation, and tamoxifen. The personal, interpersonal, and physiologic factors were depression, body image, age, relationship distress, and testosterone levels. A sample of 55 female breast cancer survivors seen for routine follow-up appointments from July 2002 to September 2002 were recruited to complete the Female Sexual Functioning Index (FSFI), Hamilton Depression Inventory (HDI), Body Image Survey (BIS), Marital Satisfaction Inventory-Revised (MSI-R), a demographic questionnaire, and have a serum testosterone level drawn. The average time since diagnosis was 4.4 years (SD 3.4 years). No associations were found between the type of cancer treatment, hormonal levels, and sexual functioning. BCS sexual functioning was significantly poorer than published normal controls in all areas but desire. The BCSs' level of relationship distress was the most significant variable affecting arousal, orgasm, lubrication, satisfaction, and sexual pain. Depression and having traditional role preferences were the most important determinants of lower sexual desire. BCSs on antidepressants had higher levels of arousal and orgasm dysfunction. Women who were older had significantly more concerns about vaginal lubrication and pain. Relationship concerns, depression, and age are important influences in the development of BCS sexual dysfunction. The relationship of testosterone and sexual dysfunction needs further study with larger samples and more accurate assay techniques.

Differences in sexual functioning between patients with benign and malignant breast tumors

Collegium antropologicum, 2004

The aim of this study was to compare differences in sexual behavior between patients with benign and malignant breast tumors. A total of 187 patients treated for breast tumors (benign or malignant) at the General Hospital >Pozega<, Croatia, filled in the questionnaire between January 2001 and May 2003. Patients were asked to fill in the questionnaire one to ten years after treatment of breast tumor, while they were on their regular control visit. Deterioration in sexual life experienced 36.27% of patients with benign tumors and 51.76% of patients with malignant tumor (p<0.01). The main reason of sex life impairment in both groups was distortion of body image perception. Most of partners did not change their behavior toward women with breast tumors (48.72% for benign group and 41.82% or malignant group, p>0.05). A great amount of women in both groups felt certain change in her >body image<, but in greater extent in malignant group (41.18% vs. 25.49%), (p<0.05). F...

Construction of an integrated sexual function questionnaire for women with breast cancer

Taiwanese Journal of Obstetrics and Gynecology, 2020

Objective: With the increasing incidence of breast cancer in young women, its side effects have extended into the sexual lives of women. However, an appropriate tool to measure the sexual function is nonexistent. The aim of this study was to develop a suitable tool to measure sexual function in women with breast cancer. Materials and methods: After conducting literature reviews regarding the sexual function characteristics of women with breast cancer, this study designed a set of integrated sexual function questionnaires, which included pertinent information and three scales. The validity of the scales was examined under the guidance of three gender studies experts and two gynecologists who are also professors. Regarding the construct validity, researchers conducted exploratory factor analysis on the measurement results of 196 women with breast cancer. Results: The integrated sexual function questionnaires included the following three scales: "Breasts' Role Self-Checklist," "Scales for Breasts' Role in the Foreplay," and "Female Sexual Function Scale for BCSs." The questionnaire tool consisted of the longitudinal time change, patients' and their partners' situation, information related to the recovery process, participants' perspective toward objectification of women's breasts, the role of breasts in foreplay during sexual activities, sexual desire, sexual satisfaction, sexual obstacle, and other self-evaluations. We first derived one factor from six questions in "Breasts' Role Self-Checklist" and named it as "The Importance of Breasts for Women." The other two factors were obtained from eight questions in "Scales for Breasts' Role in the Foreplay" and named as "Sexual Attraction to Breasts" and "Function of Breasts in Foreplay." In addition, three factors were derived from 16 questions in "Female Sexual Function Scale for BCSs" and named as "Sexual Desire," "Sexual Satisfaction," and "Sexual Obstacle." Conclusion: This study determined that these integrated scales for breast cancer survivors are suitable due to their content validity, construct validity, and high internal consistency reliability, with a Cronbach's alpha of higher than 0.9 for all the three scales.